Provider Demographics
NPI:1225189806
Name:TRAVIS, SARAH RACHEL (OD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:RACHEL
Last Name:TRAVIS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10094 CEDARWOOD DR
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:KY
Mailing Address - Zip Code:41091-8224
Mailing Address - Country:US
Mailing Address - Phone:859-361-1612
Mailing Address - Fax:
Practice Address - Street 1:581 DUDLEY PIKE
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:KY
Practice Address - Zip Code:41017-3296
Practice Address - Country:US
Practice Address - Phone:859-341-0888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1571DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist